Drug Treatment Matrix cell C5: Management/supervision: Safeguarding the community

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Society for the Study of Addiction web site

Society for the Study of Addiction



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Skills Consortium web site. Opens new window

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Management/supervision

Key studies on the influence of management and supervision on treatment’s impacts on crime and safeguarding the community, with a focus on criminal justice and child protection contexts. Examine the credentials of the most well known model for working with offenders, ask yourself why cognitive-behavioural approaches are so prominent, and explore the feasibility of focusing on the child when the parent is the patient.


S Seminal studiesK Key studiesR ReviewsG Guidancemore Search for more studies

Links to other documents. Hover over for notes. Click to highlight passage referred to. Unfold extra text Unfold supplementary text

S Watershed moment for the place of child protection in substance use policy and services ([UK] Advisory Council on the Misuse of Drugs, 2003). Though published in 2003, this report from the UK government’s drug policy advisers deserves the accolade of “seminal”. After its publication, no practitioner, manager or policy maker could justifiably claim ignorance of the need to prioritise the child while treating their parent(s) for substance use problems. It changed perspectives, lifting eyes from the direct treatment task to the family, and remains a key source for related guidance and research. Also listed below as guidance. For discussion click and scroll down to highlighted heading.

K Offender–intervention matching principles really do help (2011). Training probation officers in the risk-need-responsivity model intended to match interventions to the offender reduced the recidivism of offenders on probation. For discussions click here and here and scroll down to highlighted headings.

K Motivational interviewing style clashes with criminal justice context (2001). Actual performance of US probation staff after motivational interviewing training contradicted promising written responses, and the officers were rated as less ‘genuine’ than before – possibly because the work context limited how far they could genuinely stay true to motivational principles. Same study described in this Findings essay. Related discussion in cell B5’s bite.

K Leadership affects adoption of evidence-based practices (2008; alternative free source at time of writing). Leadership qualities including knowledge and experience and commitment to a rehabilitation focus predicted good substance use treatment practice in US criminal justice services.

K Practical way to triage offenders to appropriate sentencing/treatment (2011). US study confirmed risks of re-offending and needs related to offending (in particular for addiction treatment) are independent dimensions which can be assessed to guide sentencing and treatment in ways which reduce reoffending. For discussion click and scroll down to highlighted heading.

K Adjust drug court sentencing/treatment to offender progress (2012). One of an impressive series of studies of US drug courts, where specialist judges negotiate the offender’s treatment and supervision and regularly monitor progress. During the programme illegal drug use was reduced by triaging offenders to more or less intensive treatment/supervision and then adapting based on their response. Longer term findings (2014; free source at time of writing) on crime remained in favour of the adaptive programme, but none of the differences were statistically significant. For discussion click and scroll down to highlighted heading.

R Drug courts have the edge on usual adjudication (2012). In drug courts the judge or magistrate negotiates treatment and supervision for the offender and plays an active part in both. The most thorough and extensive review to date tentatively concludes they reduce crime compared to usual adversarial proceedings. For related discussion click and scroll down to highlighted heading.

R Female offenders particularly need holistic treatment (2008). Argues that treatment for female offenders should take into account the high prevalence of post-traumatic stress and other mental and physical health problems, and the significance for them of relationships and of their roles as mothers. Concludes that women respond best to holistic, integrated programmes which incorporate empowerment and peer mentoring, and adopt a collaborative rather than authoritarian approach.

R Substance use practitioners can build on their skills to address child protection (2007). After reviewing international research, UK-based experts on the family dimensions of substance use problems questioned the commonly reported perception of substance use treatment workers that child welfare is beyond their skills and professional comfort zones. For discussion click and scroll down to highlighted heading.

R G Specific recommendations on training for treatment in a criminal justice context (Australian Government, 2005). Uniquely focuses on training staff to treat substance use problems in a criminal justice context, formulating guidance on training and its management based on a review of research specific to this context and more generic literature and principles. For discussion click and scroll down to highlighted heading.

R G Creating and maintaining ‘family sensitive’ treatment services ([Australian] National Centre for Education and Training on Addiction, 2010). Reviews generic and substance use-specific research as a basis for guidance on workforce development policies and practices to help ensure treatment services safeguard their clients’ children. For related discussion click and scroll down to highlighted heading.

G UK clinical guidelines stress continuity of treatment for prisoners ([UK] Department of Health, 2017). Comprehensive, practice-oriented official clinical guidelines. Chapter on treatment in criminal justice systems advises against forced withdrawal from opiate-type drugs and stresses seamless transfer to treatment on release and provision of naloxone to prevent opioid overdose deaths.

G US consensus guidance on substance use treatment in the criminal justice system ([US] Substance Abuse and Mental Health Services Administration, 2005). Guidance influenced by an impressive array of practitioners and service planners and endorsed by research and practice experts. Distils best research-informed practice on topics including the selection of treatment interventions, matching these to the offender, and planning treatment programmes.

G Child protection is part of the business of substance use services ([UK] Advisory Council on the Misuse of Drugs, 2003). Results of an inquiry into children in the UK seriously affected by parental drug use. Includes (starting p. 82) guidance on incorporating child protection measures into the work of drug and alcohol services. Update published in 2006. Also listed above as a seminal report. For discussion click and scroll down to highlighted heading.

G Scottish guidance on protecting families and children advocates “whole family” recovery (Scottish Government, 2013). Guidance specific to substance use intended for all child and adult services, including drug and alcohol services. Sees treatment of the parent’s substance use as one element of a “whole family” strategy responding to the wider family’s needs, such as supporting children and enhancing parenting and resilience. The role substance use services should play in a system which (Getting our Priorities Right is the title) prioritises child welfare, including what new patients should be asked about the children in their lives. Related local toolkit listed below. For discussion click and scroll down to highlighted heading.

G ‘Toolkit’ to help practitioners safeguard children and families affected by problem substance use (NHS Lothian and partner agencies, 2014). Co-produced by health, social and enforcement authorities in the Edinburgh region. Designed to assist the day-to-day practice of health and social care practitioners working with children and families affected by alcohol and drug problems in the family, but can also act as a checklist and guidance for their managers. Getting it Right in the toolkit’s title echoes the Scottish national guidance listed above. For related discussion click and scroll down to highlighted heading.

G Key capabilities for treatment staff to work with male perpetrators of domestic violence (2015). Published by King’s College, London, and developed on the basis of UK research (2016). Helps substance use treatment services define and clarify key staff capabilities for working with male substance users who are violent to intimate partners. See also generic NICE quality standards ([UK] National Institute for Health and Care Excellence, 2016) for health and social care services on assessing and responding to domestic abuse.

G Good practice in responding to domestic and sexual violence involving substance use (2013). UK guidelines based on a government-funded project intended to improve responses to victims and perpetrators of domestic and sexual violence associated with substance use and/or mental health problems. Includes minimum standards of practice and guidance on policies and procedures. See also generic NICE quality standards ([UK] National Institute for Health and Care Excellence, 2016) for health and social care services on assessing and responding to domestic abuse.

G Australian guidance on addressing family and domestic violence in addiction treatment ([Australian] National Centre for Education and Training on Addiction, 2013). Among other functions, intended to guide managers in organising policies, procedures and staff training and development to identify and address family or domestic violence among substance use patients.

G US guidance on substance use treatment and domestic violence ([US] Substance Abuse and Mental Health Services Administration, 1997). Consensus guidance on how treatment services can identify and work with both perpetrators and victims.

G UN guide to starting and managing needle and syringe programmes in prison (United Nations Office on Drugs and Crime, 2014). Companion to WHO’s generic guide (World Health Organization [etc], 2007) to managing needle exchanges.

more Search for all relevant analyses or for subtopics go to the subject search page and hot topics on child protection and helping the families of substance users.

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